Gastric adenocarcinoma (GAC) is an extremely rare cancer in children with very limited information on the clinical presentation and outcome. We report five pediatric patients with GAC‐treated between 1990 and 2008 at our institution. Median age at diagnosis was 17 years (range: 8–17). Our case series suggests that pediatric GAC patients present with diffuse metastatic disease (four patients) and with patterns of spread similar to adult GAC. Initial chemotherapy was mainly platinum‐based. Median time to progression was 4 months. The only long‐term survivor was a patient with localized disease who had complete surgical removal of primary tumor. Pediatr Blood Cancer 2011; 57: 524–527. © 2011 Wiley‐Liss, Inc.